Childhood Cancer Outcomes

Mike Wood Excerpts

Tuesday 26th April 2022 Commons Chamber

[Maria Caulfield]

I think the names that we have read out this afternoon show that, while cancer in children only accounts for 1% of cancer cases, if you are in that 1%, it does not feel very rare at all. I thank all hon. and right hon. Members for sharing the stories of their constituents.

That means, as has been pointed out, that GPs will only see one or two cases of childhood cancer over the course of their career. These can be difficult cancers to spot because some of the symptoms reflect other illnesses and other conditions. NICE guidelines are trying to support GPs. The NG12 guidelines underpin cancer referrals. They set out detailed guidelines for GPs on the symptoms of cancer in children and recommend very urgent referrals that mean an appointment within 48 hours for children presenting with a wide range of potential cancer symptoms, from unexplained lumps to bruising or bleeding. The guidance also recognises the knowledge and insight that parents have, as it sets out that GPs should consider referrals for children where their parents are thinking that their child is not well or there is just something not quite right with them. That referral should happen when parents are concerned, even if the symptoms are most likely to have a benign cause.

[Mike Wood (Dudley South) (Con)]

Will the Minister give way?

[Maria Caulfield]

I will not, if my hon. Friend does not mind, because we do not have a huge amount of time.

NICE regularly reviews and updates these guidelines on suspected cancers. It urges GPs to think of cancers sooner and lower the referral threshold for tests, and ultimately catch cancer sooner, which does not always save lives but can make a difference if a cancer is diagnosed earlier.

To help GPs to identify signs and symptoms of these childhood cancers, online education programmes such as Gateway C are available, but also face-to-face education sessions have now resumed, including seminars offered by providers such as Cancer Research UK, and primary networks are establishing cancer clinical lead groups to share latest research and good practice.

The rarity of cancers in children, as the hon. Member for North Antrim pointed out, means that it is harder to diagnose outside a specialist setting, and many of the symptoms can mimic other illnesses. For example, diagnosing brain cancer in children is particularly challenging because it often presents in a similar way to epilepsy, and sarcoma symptoms can often start with limb pain, which is often a common complaint in children. It is therefore crucial that children up and down the country have access to specialist services in cancer care, which are not necessarily provided in most hospitals, where traditionally cancer services are arranged by cancer type. Children’s cancer services need to be contained in a small number of specialist units, which we refer to as principal treatment centres, or PTCs. Each child with a suspected cancer should be referred directly to a PTC, which will make the diagnosis and direct provision of treatment. In England, we have 14 of these centres. They manage care through the multi-disciplinary teams and drive diagnosis, treatment and, crucially, as we have heard from many Members, research participation.

As well as diagnosing the condition, the centres are expert in offering psychosocial support, helping children to continue their education and helping, as Sophie campaigned for, to provide specialist play facilities seven days a week. Sophie’s complaint was that those were only provided for five days a week. It is important that we hear from children and young people who receive a cancer diagnosis. I personally thank charities such as Young Lives vs Cancer and the Teenage Cancer Trust, which last year put together guidance for young people in England, Scotland, Wales and Northern Ireland discussing having a visitor and a hand to hold when having cancer treatment. That is useful guidance, and it has been distributed by the NHS to all our cancer alliances in England.

I will touch on the issues that Sophie in particular was campaigning on. Food was a big bugbear of hers. I think she described it as “disgusting” in some of the reports I read. We know that food is important for all patients, but particularly for children, because nutritious food is a way of aiding patients’ recovery. It is difficult in hospital. I know from my experience as a nurse that we always serve food at 7, 12 and 6, and if someone is hungry in between, it is often very difficult to get any food at all. We are working extremely hard to improve hospital food following the publication of the independent review in October 2020. The review made a suite of recommendations across several areas, including nutrition and hydration. The three-year plan, “Great Food, Good Health”, led by NHS England, is under way to implement the recommendations from that review. I hope that Sophie and her family will be pleased we are making some progress with that, because I fully recognise the complaints she made from her experience.

I will touch on research, because it came up so often in hon. and right hon. Members’ contributions. It is important that we improve not only treatment, but its side effects. We have heard from many Members that childhood cancers can have a very successful outcome in terms of survival, but often the impact of those treatments can have a lifelong effect for those with cancer and their families.

I reassure Members that research is taking place. Since 2019, the NHS has been offering whole genome sequencing to all children with cancer to enable more comprehensive and precise diagnosis and access to more personalised treatments that will reduce the number of young people experiencing long-term symptoms from their treatment. There has been a lot of progress on the treatment of childhood cancers, with the majority of children now surviving, but for certain childhood conditions, such as rhabdomyosarcoma, that is not yet the case. Research is crucial to how we deal with it in the long term.

The NIHR, which funds research across the board in the NHS, is funding childhood cancer research across its whole remit, from early translational research right through to clinical research and social care research. I am concerned by the case raised by my hon. Friend the Member for Scunthorpe of researchers in her constituency finding it difficult to access those funds and go through the application process. I am happy to meet her and the researchers to see whether we can unlock some of those jams.

There is support for research into rhabdomyosarcoma at the Royal Marsden biomedical research centre—I declare an interest, as I still work as a nurse at the Royal Marsden—the Royal Marsden clinical research facility and the Great Ormond Street biomedical research centre. We are making some great inroads in funding research into not only cancer treatments, but the effects of treatments.

There is so much more I would like to say to answer Members’ questions, but due to time I simply reassure my hon. Friend the Member for Gosport that the 10-year cancer strategy that the Secretary of State has just announced will tackle many of the issues she has raised. The call for evidence recently closed, but it is a great opportunity to put forward the case for childhood cancers, and I am happy to meet her after the debate to see whether we can push her case forward.

Health and Care Bill

Mike Wood Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Peter Dowd (Bootle) (Lab)]

I concur with the comments made by every hon. and right hon. Member today, with the exception of the Minister. There is no question but that the NHS workforce is in crisis; that is what so many organisations say. The Government response has been limited to stopgap measures, so I am grateful to the Lords for their hard work on this Bill, which has been much improved since it left the Commons. The Lords are clearly on the side of the NHS. I hope that, even at this late stage, the Government will recognise that Lords amendment 29, which I support, is perfectly reasonable, and will welcome it with open arms. If they do not, the question is: why not?

I have had many emails from nurses and other healthcare professionals who are calling for such a measure to be supported. The amendment refers to a report on workforce needs, and says that it must include independently verified assessments of current and future workforce numbers required to deliver care to the population of England. What is wrong with that? It seems perfectly sensible. Planning the NHS workforce is central to the smooth operation of the service. The Lords amendment seeks to ensure that.

In north-west England, NHS vacancy rates have increased over the past year; they are reaching 13,500. That puts huge strain on the remaining workforce. There is a chronic workforce shortage in the NHS, driven by years of insufficient investment, and that needs to change. Mental health issues, alongside covid-related absences, are having a lasting effect on the mental health of NHS staff. British Medical Association surveys have consistently shown that the pandemic has, since its start, left staff reeling, and they are increasingly burned out as a result of the lack of support.

The number of people in the general practice workforce has lagged behind demand in recent years, as people have said time after time, and the pressure is becoming unsustainable. It is driving GPs out of the workforce and threatening to destabilise general practice. That is also the case for many other allied professionals across the whole spectrum. To address that, it is vital that the Government develop and implement a detailed plan to fill workforce shortages, but they have not yet seized that opportunity. The granularity of the assessment of the workforce situation sets the scene for the bigger picture. The chronic lack of resources and support has been keenly felt in the Liverpool city region. Hospital trusts in Liverpool plan to reintroduce car parking charges for NHS workers from 1 April. After everything those workers have done during the pandemic, it is dreadful that, in the midst of a cost of living crisis, they are being asked to cough up substantial resources just to get to work.

Workers are working two, three or four extra shifts per week. That is dangerous. NHS healthcare workers in Southport and Ormskirk Hospital NHS Trust and St Helens and Knowsley NHS Trust are campaigning to be re-banded because they are doing work that they should not have to do, and that they are not necessarily trained for. That is why I support Lords amendment 29, which is sensible and proportionate. As for the Chair of the Health and Social Care Committee, I say: there are 100 healthcare and related organisations saying, “This amendment is the right thing to do.” If those on the frontline think it is the right thing to do, why do the Government not also think it is the best thing to do?

[Mike Wood (Dudley South) (Con)]

At its best, our national health service provides truly world-class care. That is down to the skill, passion and professionalism of its workforce. As hon. Members will know, I have personal reason to forever be grateful to the NHS, and particularly the staff at Russells Hall Hospital in Dudley. While new hospitals, equipment and technology are all crucial, they are nothing without the health and social care staff who are the beating heart of our health service.

However, I am concerned that Lords amendment 29 does little more than add to an already onerous level of bureaucracy in our NHS. Providing a report every two years instead of every five does not improve the record number of doctors and nurses. The Government are already committed to reviewing the long-term strategic trends in the health and social care workforce, and to developing a workforce strategy, and clause 35 of the Bill already commits to a workforce review every five years. That in itself will be quite an arduous task.

Huge steps have been taken in investing in the future of the NHS workforce, including by funding a 25% increase in places since 2016-17. That means 7,500 more medical schools training places in England over the past six years. The shadow Health Secretary is obviously right to say that the population has grown in recent decades, but I think it has grown by 8% since 2010, while the number of doctors working in our NHS is up by about one third. Clause 35 allows for medium and long-term workforce plans, and offers a sensible balance between the need for such work and the need to minimise unnecessary bureaucracy. That is why I will not support the amendment.

Turning to Lords amendment 30, while I recognise the arguments made by Opposition Members, I do not agree with them or believe that clause 40 should be removed from the Bill. I believe it contains sensible powers. We expect the Secretary of State to be responsible for our national health service—for the services provided in every part of the country. There was much opposition and controversy when provisions reducing that responsibility were introduced in previous legislation. If he is to exercise that responsibility, he must have the powers to do so.

Voters and Members of Parliament expect the Secretary of State to be able to take action where health services have been reduced. On 11 November, a few weeks before the by-election in North Shropshire, the leader of the Liberal Democrats, the right hon. Member for Kingston and Surbiton (Ed Davey), questioned the Prime Minister at Prime Minister’s questions about the closure of Oswestry ambulance service. If we are to question the Prime Minister or the Health Secretary on the closure of services such as ambulance stations or hospitals, then it is only right that the Secretary of State should, in extreme circumstances, have the power prevent those closures. Our voters expect that, and frankly so do the Opposition.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I wish to speak to Lords amendment 29 on the workforce. The most important thing I learned during my five years as a shadow Health Minister is that everything comes back to the workforce. We can have the grandest plans, strategy documents, reorganisations, integrations and configurations—all of which are probably in this Bill, in various forms—but it will all count for very little if the fundamental cog in the machine, the workforce, is not a central part of those plans. The consistent failure to invest in, and provide a plan for, the workforce, so that it can meet demand over a sustained period is at the root of the challenges that the NHS and social care face today. We now have a chance to correct that.

Let us look at some of the challenges. There are 93,000 NHS staff vacancies; £6 billion-plus has been spent on temporary staff to fill gaps; and more than half of staff are working unpaid extra hours each week, with 44% saying that they have felt ill with work-related issues—little wonder, given that retention remains a huge issue. We need a plan, and we need to give staff some semblance of hope that we are listening—that the claps on a Thursday were not just an empty gesture; that the tributes that we rightly pay here to their dedication are not meaningless platitudes; and that there is a determination to do something about the persistent rota gaps that mean that staff are both exhausted and demoralised.

The Health and Social Care Committee report on staff burnout says:

“It is clear that workforce planning has been led by the funding envelope available to health and social care rather than by demand and the capacity required to service that demand.”

That is rather the nub of it. Health and social care are both demand-led systems, yet the funding and therefore the workforce capacity are not linked to demand. Until that central issue is addressed, we will keep coming back to the many varied and unfortunate consequences of an overstretched and under-resourced workforce.

I suspect that the Minister—who I have a lot of time for, even though he is often wrong on these things—might privately think that a long-term workforce plan might be a good idea, not just to ensure that the NHS can plan properly and to move forward on a sustainable footing, but because that might help his Department when it goes into negotiations on the spending round with the Treasury, as it will be able to point to an independently verified assessment of workforce need. If the amendment has a weakness, it is that it does not ensure that any plan is actually feasible, because there is no requirement in it that any plan be fully funded. However, a plan that shows, for all the world to see, a clear funding gap would be helpful to the Minister, because it would allow him to go to the Treasury with a clear and objective demand. As he knows, I like to be helpful to him, so I hope that on this occasion he can support the amendment.

This debate is timely because it comes on a day when two surveys have been released that lay bare the crisis that we face. One survey shows that public satisfaction ratings with the NHS are reported to be at a 25-year low—a quarter of a century of surveys there—and another shows that the number of NHS staff who would recommend their trust as a place to work has plummeted. Those two facts are intertwined and symptomatic of the workforce crisis that the amendment is trying to address.

The question we must ask ourselves, if we choose not to support the Lords amendment, is whether the Government’s existing plans create sufficient accountability and rigour to deliver the transformative approach that the amendment would. In my view, it introduces a level of robustness to workforce planning that is currently missing. For the reasons I have set out, we owe it to the workforce, to patients and to those in receipt of social care to put workforce planning on the strong footing that the amendment would deliver.

Covid-19: Purchasing Effort

Mike Wood Excerpts

Thursday 3rd February 2022 Commons Chamber

[Edward Argar]

I am grateful to the hon. Lady; to be fair, we may not always agree, but she always makes thoughtful points and knows this subject well. However, many right hon. and hon. Members across the House have regularly said that Exercise Cygnus gave everyone everything they needed to know in how to manage this pandemic, which is completely not the case. That was a flu pandemic exercise with a number of preconditions, one of which was that, at a certain point, it was assumed that antivirals would become available within—I think, off the top of my head—nine weeks of the pandemic beginning. That was not the case, because we were dealing with a completely new virus, so although there are valuable lessons to be learned, we need to be very careful about drawing direct parallels.

The hon. Lady rightly talked about the sum of money and highlighted the impact. She is right that £8.7 billion is a very significant sum of public money, but she also must acknowledge that that £8.7 billion was not wasted, because the PPE exists. This is an accounting point about what the purchase price was compared with the value now, with a stable marketplace for that. Only a very small fraction of that stockpile has been deemed not fit for use and, in those cases, we continue to investigate, through contractual mechanisms and elsewhere, what we can do to recover that money.

[Mike Wood (Dudley South) (Con)]

The embassy of one of our major international partners had to send staff to Sofia with a suitcase of money handcuffed to their wrist in order to procure PPE for their health and social care. Does my hon. Friend not think that the Opposition would be better off celebrating the herculean efforts that meant that PPE could be got to our NHS providers and our local authority and social care providers, rather than engaging in such transparently cynical party political point scoring?

[Edward Argar]

I agree entirely with my hon. Friend. As I said in response to the SNP Front-Bench spokesman, the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar), I hope the whole House could agree on paying tribute to all those civil servants and others who moved heaven and earth to ensure that we got the PPE that we needed for the frontline. That is the most important factor. We did what we needed to get the PPE to protect people and to protect lives.

Oral Answers to Questions

Mike Wood Excerpts

Tuesday 18th January 2022 Commons Chamber

[Maggie Throup]

The hon. Lady makes a really good point. I reassure her that procedures for urgent cases have not been cancelled. As the House knows, we are looking at the private sector to help deliver vital support for those patients.

[Mike Wood (Dudley South) (Con)]

4. What assessment he has made of the capacity of the UK’s covid-19 testing infrastructure in comparison to other countries.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)]

The UK continues to provide one of the highest testing rates globally. We have increased capacity for PCR testing by over 200,000 tests per day since December. Home delivery capacity is now at 7 million lateral flow tests every day, with community pharmacies supplying an additional 9.5 million tests last week. In comparison to England, countries that have put in place more restrictions might have chosen a different balance between lateral flow devices and PCRs to meet their individual testing demands. Therefore, we cannot meaningfully compare our testing infrastructure to that of other countries.

[Mike Wood]

I thank the Minister for that answer. Health and social care workers who care for some of the most clinically vulnerable members of our society were rightly prioritised for early vaccination. Does she agree that, similarly, they must be prioritised for testing? What is she doing to ensure that?

[Maggie Throup]

My hon. Friend makes a good point. The most vulnerable people are being prioritised. The UK Health Security Agency and NHS Test and Trace currently deliver an average of more than 70,000 PCR kits and 970,000 LFD kits a week to adult social care settings. In recent weeks, as demand has increased due to the omicron wave, Dudley, like other local authorities, has provided tests to key workers to enable them to keep working.

Health and Social Care

Mike Wood Excerpts

Friday 3rd December 2021 Commons Chamber

[Edward Argar]

My hon. Friend is absolutely right to highlight that. My hon. Friend the Minister for Care and Mental Health has done a huge amount of work on both investment and working with local systems to improve hospital discharge for those who do not need to be in hospital any more, to give them that step-down support, be that domiciliary care or in other settings. In the current context, we must do that safely, but she is working extremely hard to deliver that and doing a fantastic job.

[Mike Wood (Dudley South) (Con)]

The investment that the Minister has announced together with the 100 community diagnostic hubs will make a big difference in helping people to get the referrals that they need. Does my hon. Friend agree that early diagnosis depends on being able to see the appropriate clinician face to face where necessary, whether in hospital or in a GP’s surgery?

[Edward Argar]

My hon. Friend is right. The key words are “where necessary”, and that is a clinical judgment. I have highlighted the improvements that we are seeing in terms of the number of face-to-face appointments going up in primary care. Equally, we do not want to lose the benefits of telephone appointments or other appointments for those who wish to interact in that way. It is about trying to craft the system around the patient and taking those clinical judgments into account.

Covid-19 Update

Mike Wood Excerpts

Monday 29th November 2021 Commons Chamber

[Sajid Javid]

My right hon. Friend is right to raise the difference between Wales and England in the approach taken. I feel—like him, I think—that we have taken the right approach to face masks. I welcome his support today.

[Mike Wood (Dudley South) (Con)]

My right hon. Friend rightly highlights the role of South Africa’s excellent testing and analysis system in identifying omicron. It would be perverse if South Africa were treated less favourably as a result of the resources that it has put into such analyses. Will he look at neighbouring red list countries that have much lower testing and analysis levels, to see whether travel restrictions for some of those countries might be appropriate to keep people in this country safe?

[Sajid Javid]

We will keep that issue under review. My hon. Friend is right to speak, as hon. Members across the House have done, about the importance of South Africa’s handling the matter in such a professional and exemplary way. It might reassure him to know that in the G7 meeting that I chaired earlier, we agreed unanimously about that issue and about the importance of continuing to work with and support South Africa.

Health Incentives Scheme

Mike Wood Excerpts

Friday 22nd October 2021 Commons Chamber

[Maggie Throup]

My hon. Friend makes a very good point. We are investing some money in the new pilot and we are confident that it will give us some outcomes that we can work on to take measures forward. If we can save a fraction of the £6 billion, it will be still be a huge saving for people’s health, but, obviously, we want to make sure that this is about saving money and saving lives.

[Mike Wood (Dudley South) (Con)]

I am tempted to ask the Minister whether bobbing in this place might count towards the app’s incentives. I know that all Members will appreciate my hon. Friend’s courtesy in making a statement to the House rather than this being announced in a press conference later in the day. As well as the national steps challenge, the Singapore Government launched its Healthy 365 app around a year ago. Will the Minister be looking both at Governments around the world and at businesses and public sector organisations in the United Kingdom that already operate app-based fitness incentives to make sure that we learn from the best and avoid replicating others’ mistakes?

[Maggie Throup]

My hon. Friend makes a very good point. Yes, we know that there is a lot of experience out there and we want to pull everything together to make sure that we have an effective pilot and know how we move forward from that to help people to get healthy, get fit and enjoy good lives.

Covid-19 Update

Mike Wood Excerpts

Monday 6th September 2021 Commons Chamber

[Nadhim Zahawi]

I certainly urge all 16 and 17-year-olds to come forward to get their jab and the protection and freedoms that go with it. I thank the “Grab a Jab” team in Aylesbury for all the work they have done.

[Mike Wood (Dudley South) (Con)]

The strongest incentive for getting the vaccine is obviously to protect yourself and your loved ones. Although the risk of covid to secondary school-age children may be low, the risk to those they live with could be much higher. Will the chief medical officers consider offering covid vaccines to 12 to 15-year-olds who live with immunosuppressed or other extremely clinically vulnerable people in their household?

[Nadhim Zahawi]

My understanding is that, for 12 to 15-year-olds who are healthy, the chief medical officer is looking at the impact on them specifically, whether it be their mental health or the other impacts of disruption to education. He is consulting widely with local directors of public health and the Royal Colleges.

Covid-19 Update

Mike Wood Excerpts

Monday 12th July 2021 Commons Chamber

[Sajid Javid]

The right hon. Gentleman may know that when we set the 16 August date, and I think I made this clear in the statement last week, it was based on clinical advice—the public health advice that we received and in particular that it was better to make sure that more people are vaccinated than will be on 19 July, and I think that is valuable advice. When it comes to masks, I think I have made the Government’s position clear.

[Mike Wood (Dudley South) (Con) [V]]

Lifting legal restrictions is a massive relief for all those who rely on pubs, restaurants and nightclubs for their livelihoods, the overwhelming majority of which are taking their responsibilities seriously at enormous cost to themselves. Does my right hon. Friend agree that as we open up our society and economy, not only must all hospitality businesses take sensible steps to protect us from disease, but all customers must also play their part and respect venues and their staff, who are working so hard to do the right thing?

[Sajid Javid]

Yes, I agree wholeheartedly with my hon. Friend. It is a responsibility as we open up not just for the owners of the businesses, the nightclubs and the pubs to take that sensible, measured attitude, but for customers to give a thought to those who are serving them at the table or behind the bar and to be respectful of their needs.

Covid-19 Update

Mike Wood Excerpts

Tuesday 6th July 2021 Commons Chamber

[Sajid Javid]

I am looking closely at those recommendations. I want to look at the expert advice of everyone out there who is providing good, sensible advice about how we can come together to tackle this pandemic. The hon. Lady is right to point out that the pandemic has, sadly, been disproportionate in certain communities and in its impact, including, sadly, on disabled people and people from ethnic minorities. That is true not just in the UK; it is true across the world, and we need to work out a plan to deal with that, and also, if there is ever a future pandemic, to ensure that we have learned the lessons.

[Mike Wood (Dudley South) (Con)]

Clearly, our protection against further waves of the virus depends on the uptake of vaccines. Will my right hon. Friend look at how the daily infection, hospital admission and death statistics can be broken down by age group and by vaccination status, so that everybody can see the benefits of vaccination for themselves and for others?

[Sajid Javid]

The vaccines are our wall of protection. That is what is allowing us to make the decisions that we have made to restore our freedoms and continue down that road, and I think providing more information and detail on the take-up, especially by age group and locality, can be helpful.